Platelet function and factor VIII in uremia

We studied platelet function and plasma factor VIII in 15 healthy individuals and 41 uremic patients to evaluate the effect of dialysis on the hemostatic defect in uremia. Platelet counts and bleeding times were normal in all subjects. Platelet retention on glass beads was significantly reduced in all uremic patients. Platelet aggregation induced by collagen and ADP were significantly reduced in uremic patients on conservative therapy. ADP-induced platelet aggregation was normal but collagen-induced aggregation remained abnormal in hemodialysis (HD) patients. Both ADP- and collagen-induced aggregation were normal in patients on continuous ambulatory peritoneal dialysis (CAPD). FVIII: C was normal in all uremic patients. Both FVIII:vWF and FVIII R:Ag were significantly elevated in all uremic patients. In conclusion, platelet function was significantly defective and FVIII:vWF and FVIII R:Ag significantly elevated in uremia. HD and CAPD did not influence factor VIII levels or function nor did they improve platelet retention. Platelet aggregation improved partially on HD and completely on CAPD.

The effects of diet and exercise in the treatment of non-insulin dependent diabetes mellitus

Diet and exercise could be an essential part of the treatment of non-insulin dependent diabetes mellitus (NIDDM). The effects of a strict dietary restriction (800–1,200 Kcal/day) with exercise (2-hour walk per day) on glycemic control were evaluatedin NIDDM patients. A short-term study was performed on 147 cases In these cases, the duration of hospitalization was 7–14 days. We achieved glycemic control [fasting blood sugar (FBS) less than 140 mg/dl] in 112 cases (76%). Among them, 78 (53%) were controlled with diet and exercise only and in 34 (23%), control was induced with oral gliquidone treatment for about 5 days A long-term study was done on 76 cases who followed our program for from 1 to 12 months (mean : 3.8 months) after discharge. Glycemic control was maintained in 56 (74%) in spite of the insignificance of the amount of weight reduction. Glycemic control was significantly related to the duration of diabetes, diabetic complications and the peak C-peptide level, but was unrelated to the initial body weight, FBS levels and HbA1c levels. These data indicate that a program of diet and exercise must be an integral part in the treatment of NIDDM. This was true, especially, for patients who have had adequate insulin secretory capacity few diabetic complications, short duration of disease, and no previous history of oral hypoglycemic agents or insulin therapy.

DNA-RNA hybrid secondary structures

DNA-RNA and DNA-DNA duplexes are even more polymorphic than observed previously. DNA-RNA hybrids can have secondary structures like A-DNA or A-RNA, but double helices of the synthetic DNA-RNA hybrids poly(dA) X poly(rU) and poly(dI) X poly(rC), respectively, form 11-fold and 10-fold double-helical structures in which the two chains have quite different conformations. Extensive X-ray fiber diffraction analyses show that in both structures the DNA chains have C-2'-endo-puckered furanose rings, while the anti-parallel RNA chains have C-3'-endo-puckered rings. The bidirectional properties of such duplexes may be important in the transfer of biological information from nucleic acids.

Ferrokinetics in patients on CAPD: influence of CAPD on the anemia of uremia

Ferrokinetic studies were performed with 59Fe-citrate to evaluate erythropoietic activity in CAPD patients and to investigate the mechanism(s) by which the hematocrit increases in CAPD patients. Plasma iron disappearance rate (PID), plasma iron turnover rate (PIT), red cell iron utilization (RCIU), red cell iron turnover rate (RCIT) and marrow transit time (MTT) were all “normal” in uremic patients not yet on dialysis (Hct 23.8±3.4%), CAPD patients with persistently low hematocrit (Hct 24.9±1.8%) and CAPD patients with improved hematocrit (Hct 32.4±3.1%). Compared to these uremic patients, patients with iron deficiency anemia and normal renal function (Hct 28.0±5.1 %) had significantly faster PID and MTT and significantly higher RCIU and RCIT. Plasma volume was significantly reduced (to normal level) in CAPD patients with improved hematocrits.

The results of this study suggest that erythropoietic activity is inadequate for the degree of anemia in CAPD patients as well as uremic patients not on dialysis and further suggest that the hematocrit increases in CAPD as a result of decreased plasma volume.

Prevalence of serum and milk antibodies to Giardia lamblia in different populations of lactating women

We used an enzyme-linked immunosorbent assay system to compare prevalence and levels of systemic and local antibody to Giardia lamblia in different populations. Serial blood and milk samples were collected simultaneously from lactating women in Texas and Mexico. IgG antibody to G. lamblia was present in 118 (77%) of 153 sera from 27 Mexican mothers but in only 51 (24%) of 214 sera obtained from 28 Texan mothers (P less than .001). Sera positive for IgG antibody to G. lamblia revealed antibody levels that were significantly higher in Mexico than in Texas (0.325 +/- 0.076 vs. 0.219 +/- 0.079 optical density units). Secretory IgA antibody to G. lamblia was found in 121 (79%) of 153 milk samples in the Mexican population, but in only 33 (15%) of 214 samples in the Texan population (P less than .001). The levels of secretory antibody to G. lamblia also were higher in the Mexican population. The study documents a widely different antibody response to G. lamblia in individuals living in different areas. As antibodies to G. lamblia can be acquired by infants transplacentally or through breast-feeding, this difference might be important in the relative protection against giardial infection.

Taste acuity and zinc status in chronic renal disease

The malnutrition often associated with progressive renal failure may be related to a progressive deterioration of taste acuity. To determine the relationships between taste acuity, zinc status, and progressive renal failure, 27 subjects were divided into three groups and classified as having mild, moderate, or severe renal failure, with creatinine clearance of 41 to 75, 15 to 40, and 5 to 14 ml/minute, respectively. The subjects were evaluated for recognition taste thresholds for sour and sweet by the Cornsweet method. Serum, urinary, and salivary levels for zinc were determined by atomic absorption techniques. Food diaries were kept for two days; intakes of protein and zinc were calculated from the diaries. There was a significant (p less than .01) inverse relationship between creatinine clearance and recognition taste thresholds for sour and sweet. Serum zinc levels were significantly lower (p less than .01) for subjects with severe renal failure than for subjects with mild renal failure. The subjects who ingested more protein also ingested more zinc.

Response of patients with irritable bowel syndrome and lactase deficiency using unfermented acidophilus milk

Acidophilus milk has been reported to help patients with irritable bowel syndrome by correcting the "imbalance of flora" and to be tolerated better by lactase-deficient subjects by providing bacterial lactase in the small intestine. In a double-blind randomized study, 61 lactase-sufficient patients with irritable bowel syndrome each ingested 240 ml of milk three times a day for 2 wk and the same amount of acidophilus milk for an additional 2 wk. The degree of symptoms during the two milk-drinking periods was the same as during the control periods. Also, 18 lactase-deficient patients ingested unaltered milk for 1 wk and acidophilus milk for 1 additional wk. There was no difference in the degree of tolerance to the two varieties of milk. In summary, patients with irritable bowel syndrome were not helped by the ingestion of acidophilus milk, and lactase-deficient patients were as intolerant to acidophilus milk as to unaltered milk.

Effects of exogenous and endogenous histamine on the respiratory system

There is a statistically strong correlation between the increase of the histamine concentration in the arterial plasma and the increase of airway resistance. The histamine causes a reflex bronchoconstriction on the sensory receptors. Histamine in low concentration increases the unspecific reaction in the bronchial system. This can also be achieved using low concentrations of allergen aerosols. Patients with chronic obstructive bronchitis show high concentrations of histamine in the sputum. The bronchoconstrictive potency of this histamine was found to be not always active. Higher concentrations of histamine can be liberated by washing the inner surface of the bronchial tree. Histamine injected in similar concentrations as that measured in the sputum causes bronchoconstriction. There should be high concentrations of histamine receptors as well as mast cells near the surface of the mucosa of the bronchial wall. There are many questions remaining open, which will be discussed.

A Comparison of the Mojonnier and Roese-Gottlieb Methods for Determining Milkfat Content of Ice Cream

Twenty-two samples of commercial ice cream were analyzed for milkfat content by the Mojonnier and Roese-Gottlieb methods. These samples were tested in duplicate by two analysts and results were compared. The Roese-Gottlieb method gave consistently lower results on the same sample than did the Mojonnier method. There was a wide variation in test results from the two methods. The Roese-Gottlieb test results ranged from 0.10 to 0.30% less than those of the Mojonnier test on the same samples, the Roese-Gottlieb results averaging 0.16% lower than those of Mojonnier method. These variations are highly significant and are attributable to the different amounts of alcohol used for fat extraction.